Background
Methods
Participants
Study Instruments
Data Analysis
Ethics Approval
Results
Response rates
Total (n = 166) | GPs (n = 114) | Nurses (n = 52) | ||||
---|---|---|---|---|---|---|
N | % | N | % | N | % | |
Gender
| ||||||
Male | 80 | 48.2 | 76 | 66.7 | 4 | 7.7 |
Female | 86 | 51.8 | 38 | 33.3 | 48 | 92.3 |
Years Experience
| ||||||
0-5 | 7 | 4.2 | 7 | 6.1 | 0 | 0 |
6-10 | 6 | 3.6 | 5 | 4.4 | 1 | 1.9 |
11-20 | 55 | 33.1 | 38 | 33.3 | 17 | 32.7 |
20+ | 98 | 59.1 | 64 | 56.1 | 34 | 65.4 |
PC Training
| ||||||
Yes | 53 | 31.9 | 17 | 14.9 | 36 | 69.2 |
No | 113 | 68.1 | 97 | 85.1 | 16 | 30.8 |
Reason for no post grad. Training
| (n = 113) | (n = 97) | (n = 16) | |||
Lack of time | 79 | 69.9 | 67 | 69.1 | 12 | 75.0 |
Lack of course | 14 | 12.4 | 13 | 13.4 | 1 | 6.0 |
Lack of interest | N/A | - | 12 | 12.4 | N/A * | - |
Other | 8 | 7.1 | 5 | 5.1 | 3 | 19.0 |
Service provision
Total (n = 166) | GPs (n = 114) | Nurses (n = 52) | ||||
---|---|---|---|---|---|---|
N | % | N | % | N | % | |
After Hours Service Provision by their Service
| ||||||
Calls | 102 | 61.4 | 68 | 59.6 | 34 | 65.3* |
Visits | 122 | 73.5 | 80 | 70.2 | 42 | 80.7 |
EPC Items
| ||||||
Use generally | N/A | 84 | 73.7 | N/A** | ||
Aware can use for PC planning | N/A | 60 | 52.6 | N/A** | ||
Tel. Triage Protocol in Area
| ||||||
Yes | 50 | 30.1 | 16 | 14.0 | 34 | 65.4 |
No | 52 | 31.3 | 42 | 36.9 | 10 | 19.2 |
Don't Know | 64 | 38.6 | 56 | 49.1 | 8 | 15.4 |
Aware of PC Resources
| ||||||
Yes | 102 | 61.5 | 67 | 58.8 | 35 | 67.3 |
No | 64 | 38.5 | 47 | 41.2 | 17 | 32.7 |
Current Services
Satisfactory
| ||||||
(agree or strongly agree combined) | ||||||
Hospital discharge planning | 107 | 64.5 | 79 | 69.3 | 28 | 53.8 |
Home care planning | 141 | 84.9 | 100 | 87.7 | 41 | 78.8 |
After hours service provision | 123 | 74.1% | 88 | 77.2 | 35 | 67.3 |
Factors impacting on after hours PC service
Factors which may impact on after hours PC services | GPs | Nurses |
---|---|---|
Poor communication between GPs & nurses | 82% | 85% |
High cost of locum services | 54% | 67% |
Patients unwilling to call after hours services | 59% | 62% |
Nurses unsafe at night | 41% | 63% |
Limited mobile phone coverage | 40% | 44% |
Limited access to emergency medication | 69% | 71% |
Limited availability of GPs after hours | 76% | 90% |
Limited availability of PC nurses after hours | 79% | 83% |
No access to interpreters after hours | 49% | 54% |
GPs | Nurses | ||||||
---|---|---|---|---|---|---|---|
Question | N | M | SD | N | M | SD |
tscore |
Poor communication between GPs & nurses | 112 | 1.73 | .92 | 52 | 1.71 | .83 | .14 |
High cost of locum services | 104 | 2.66 | 1.36 | 49 | 2.41 | 1.44 | 1.06 |
Patients unwilling to call after hours services | 112 | 2.53 | 1.07 | 51 | 2.43 | 1.10 | .53 |
Nurses unsafe at night | 111 | 2.81 | 1.09 | 52 | 2.33 | 1.00 | 2.70* |
Limited mobile phone coverage | 111 | 2.84 | 1.15 | 52 | 2.56 | 1.20 | 1.43 |
Limited access to emergency medication | 112 | 2.24 | .92 | 52 | 1.88 | .88 | 2.34** |
Limited availability of GPs after hours | 112 | 2.09 | 1.13 | 51 | 1.61 | .94 | 2.66* |
Limited availability of PC nurses after hours | 112 | 2.08 | 1.14 | 51 | 1.82 | .93 | 1.41 |
No access to interpreters after hours | 110 | 2.98 | 1.43 | 49 | 2.63 | 1.37 | 1.44 |
Strategies to Improve After Hours PC Services
Strategies that may improve after hours PC | GPs | Nurses |
---|---|---|
Standardised written protocol | 86% | 87% |
Individual patient protocol | 91% | 88% |
Formal protocol between PC service & indigenous Australians | 63% | 87% |
Regular multidisciplinary meetings | 70% | 92% |
Referral to PC service at time of diagnosis | 69% | 63% |
More nurses for home visits | 82% | 81% |
PC trained nurse on after hours tel. service | 86% | 92% |
PC trained respite carers | 90% | 94% |
More support and debriefing for GPs/nurses | 76% | 87% |
More support for carers | 58% | 96% |
More specific PC beds in local hospitals | 54% | 23% |
Greater access to equipment for home care | 83% | 83% |
Legislation to allow nurse evaluation of death | 58% | 87% |
GPs | Nurses | ||||||
---|---|---|---|---|---|---|---|
Question | N | M | SD | N | M | SD | t |
Standardised written protocol | 112 | 1.78 | .91 | 51 | 1.53 | .76 | 1.70 |
Individual patient protocol | 112 | 1.75 | .86 | 52 | 1.60 | .82 | 1.09 |
Formal protocol between PC service & indigenous Australians | 104 | 2.66 | 1.56 | 51 | 1.90 | .99 | 3.19* |
Regular multidisciplinary meetings | 111 | 2.19 | 1.01 | 52 | 1.63 | .74 | 3.53* |
Referral to PC service at time of diagnosis | 111 | 2.13 | 1.07 | 51 | 2.12 | .95 | .05 |
More nurses for home visits | 110 | 2.09 | 1.18 | 52 | 1.67 | .86 | 2.29** |
PC trained nurse on after hours tel. service | 111 | 1.80 | .93 | 51 | 1.33 | .55 | 3.33* |
PC trained respite carers | 110 | 1.79 | .73 | 51 | 1.39 | .57 | 3.44* |
More support and debriefing for GPs/nurses | 110 | 2.15 | .96 | 52 | 1.73 | .84 | 2.73* |
More support for carers | 111 | 1.89 | .98 | 52 | 1.62 | .57 | 1.90 |
More specific PC beds in local hospitals | 77 | 2.01 | 1.24 | 16 | 1.44. | .51 | 1.82 |
Greater access to equipment for home care | 107 | 1.91 | .88 | 49 | 1.96 | .96 | -.34 |
Legislation to allow nurse evaluation of death | 112 | 2.61 | 1.34 | 52 | 1.71 | .83 | 4.40*** |